Recorded presentation

Elinor A Graham, MD, MPH, Department of Pediatrics, Harborview Medical Center, University of Washington, MS 359774, 325 9th Ave, Seattle, WA 98104, 206-341-4609, ellieg@u.washington.edu, Stephanie De Hart, RDH, Dental, Harborview Medical Center, University of Washington, 325 9th Ave, Seattle, WA 98104, and Marco AM Alberts, DMD, MPH, Dental, University of Washington, Harborview Medical Center, 325 9th Ave, Seattle, WA 98104.

Early childhood caries (ECC) disproportionately affect low-income children from minority groups in the United States. In Washington State, the utilization of Medicaid insurance for dental care is less than 30% for children under age twenty. In 1998, a demonstration ECC prevention project was started in a low-income primary care pediatric clinic. Preventive services included oral health education at each well child visit, up to 3 fluoride varnish applications before 24 months of age, and referral to dentists who accepted Medicaid pediatric patients. In spite of strong provider interest, the rate of billed varnish applications remained low until addition of a dental hygienist coordinator who worked 4 hours per week. A year after adding this position, the number of varnish applications more than doubled. Specific activities done by the coordinator which contributed to improved use of fluoride varnish included: 1) establishing an oral health education and procedure protocol for each scheduled well child visit, 2) oral health education to all providers about ECC, 3) computerization of billing for visits and improved billing training of providers, 4) regular stocking of materials for education and varnish application in each exam room, 5) personalized feedback to providers each month about the number of varnish applications that they documented and 6) tracking of children who received varnish applications. Medicaid reimbursement from the additional varnish applications can cover the costs of the coordinator position and supplies.

Learning Objectives: At the conclusion of the session, participants will be able to

• Describe the components of an early childhood caries prevention program in a pediatric clinic
• List activities done by an oral health coordinator that enhance the number of fluoride varnish applications done by providers

Keywords: Child Health, Oral Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: University of Washington
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employed by the University of Washington

Recorded presentation